二氧化碳描记对于未插管的急诊患者很有价值[图]
![二氧化碳描记对于未插管的急诊患者很有价值[图]/Capnographyinnon-tracheallyintubatedemergencypatientsasanadditionaltoolinpulseoximetryforprehospitalmonitoringofrespiration./](/Images/2004/6/16/22/18/29/82_1.GIF) |
急救系统运送创伤较小的患者时通常只监测脉搏血氧饱合度。在入院前恶劣的监护条件下，脉搏血氧饱合度监测常常发生故障。奥地利学者Kober等研究了应用二氧化碳描记术对非插管的创伤患者进行监测的效果。他们认为这是一种有效而简便的监测方法。
科研人员共研究了70位未插管的创伤患者，分别对血氧饱和度和二氧化碳描记的生命变量和故障的数量及发生时间的记录进行采样。研究结果表明，血氧饱和度组和二氧化碳描记组的总报警数量(63 vs 10)、每一患者报警数(3.3/1.9 vs 0.3/0.9)(均数/标准差)、总故障时间(191.5/216.7秒 vs 11.8/40.2秒)、每一报警的故障时间(58.3/71.4秒 vs 5.5/14.6秒)、运送过程中故障时间百分比(13.2%/15.3% vs 0.8%/2.8%)均明显不同(P<0.01)。
研究者认为，虽然脉搏血氧饱和度监测是急诊监护监测中的标准方法，但是二氧化碳描记术是一种很有帮助的监测设备。因此他们建议在运送病员过程中使用二氧化碳描记术作为一种附加的监测工具可以缩短缺乏生命指标监测的时间段。
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Anesth Analg. 2004 Jan;98(1):206-10.
Capnography in non-tracheally intubated emergency patients as an additional tool in pulse oximetry for prehospital monitoring of respiration.
Kober A, Schubert B, Bertalanffy P, Gorove L, Puskas T, Gustorff B, Joldzo A, Hoerauf K.
Vienna Red Cross, Van Swieten and the Research Institute of the Vienna Red Cross, Vienna, Austria.
, 百拇医药
Victims of minor trauma transported by paramedic-based rescue systems are usually monitored with pulse oximetry. Under the difficult surroundings of prehospital trauma care, pulse oximeters show considerable periods of malfunction. We tested the hypothesis that capnography is a good, easy to use tool for monitoring in nonintubated trauma victims. Seventy nonintubated trauma victims were included in this study. Vital variables and number and time of malfunctions were sampled for oximeter and capnometer recordings. Total number of alerts (63 versus 10), number of alerts per patient (3.3 [1.9] versus 0.3 [0.9]) (mean [SD]), total time of malfunction (191.5 [216.7] s versus 11.8 [40.2] s), time of malfunction per alarm (58.3 [71.4] s versus 5.5 [14.6] s), and the percentage of malfunction time during transport (13.2% [15.3%] versus 0.8% [2.8%]) differed significantly (P < 0.01) between oximetry and capnography. Although pulse oximetry is a standard method of monitoring in emergency care, we found capnography to be helpful as a monitoring device. We consequently recommend the use of capnography on transport as an additional monitoring tool to reduce periods lacking supervision of the vital variables. IMPLICATIONS: Capnography is a useful tool to improve respiratory monitoring in nonintubated trauma victims on emergency transport and an easy to use supplement to pulse oximetry., 百拇医药